桡骨远端不稳定骨折的手术治疗

目的 探讨桡骨远端不稳定骨折的治疗方法及效果。方法 自2000年1月～2004年3月。根据不同的骨折类型分别采用闭合复位经皮克氏针固定、切开复位掌侧支持钢板内固定、闭合复位或有限切开内固定加外固定支架以及切开复位记忆合金内固定治疗桡骨远端不稳定骨折63例66侧。术中进行自体骨移植17侧。结果 63例患者中有58例60侧获随访，随访时间为5～28个月(平均14个月)。腕关节功能按Sarmiento标准进行评定，优27侧，良20侧，可9侧，差4侧。并发症包括钉道感染5侧，骨干部骨不连1侧，腕管综合征1侧，创伤性骨关节炎2侧。结论 桡骨远端不稳定骨折应根据不同的骨折类型采用不同的手术方法，每一种方法应掌握好其适应证。

Surgical treatment of unstable distal radius fractures

Objective To explore and evaluate the surgical treatments of unstable distal radius fractures. Methods 63 cases(66 sides) of fracture of unstable distal radius were treated according to the fracture type respectively with one of the following methods: close reduction and percutaneous K wires, open reduction and internal fixation with volar buttress plate, close reduction and external fixation with or without limited internal fixation, and memory alloy fixation. Bone grafting was used at 17 sides. Results Of the 63 cases, 58 (60 sides) were followed up from 5 to 28 months (averaging 14 months). The functions of the wrist were evaluated by Sarmiento scale. 27 sides were excellent, 20 good, 9 fair and 4 poor. Complications included pin track infection at 5 sides, metaphyseal non union at 1 side, wrist tube syndrome at 1 side and traumatic arthritis at 2 sides. Conclusion Surgical treatments of unstable distal radius fracture should be varied with specific fracture types each of which should have its own indication of the surgical method.